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General NPI Number Information
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NPI Number | 1801018049
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Entity Type | Organization
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Legal Business Name | CENTRE FOR ALTERNATIVE MEDICINE, INC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 460 STATE ROAD 436 SUITE 200
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City | CASSELBERRY
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State | FL
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Zip | 32707-4970
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Country | US
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Telephone | 407-657-2433
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Fax |
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Provider Business Mailing Address
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Address Line | 460 STATE ROAD 436 SUITE 200
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City | CASSELBERRY
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State | FL
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Zip | 32707-4970
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Country | US
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Telephone | 407-657-2433
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK WILLIAM HARRIS
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Credential | D.C.
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Telephone | 407-657-2433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0005746
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License Number State | FL
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